Provider Demographics
NPI:1053332726
Name:ASHLEY COTHERN, HOLLY TRIMBLE (MD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:TRIMBLE
Last Name:ASHLEY COTHERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:TRIMBLE
Other - Last Name:ASHLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:236 W 6TH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4517
Mailing Address - Country:US
Mailing Address - Phone:775-337-8400
Mailing Address - Fax:775-337-8407
Practice Address - Street 1:236 W 6TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4517
Practice Address - Country:US
Practice Address - Phone:775-337-8400
Practice Address - Fax:775-337-8407
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11793207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
11614661OtherCAQH
11614661OtherCAQH